Provider Demographics
NPI:1609820505
Name:LEE, LAURA PENTON (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:PENTON
Last Name:LEE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2401 S GESSNER RD
Mailing Address - Street 2:APT 336
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2056
Mailing Address - Country:US
Mailing Address - Phone:318-623-9920
Mailing Address - Fax:318-473-4007
Practice Address - Street 1:3030 S GESSNER RD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3765
Practice Address - Country:US
Practice Address - Phone:713-587-0909
Practice Address - Fax:713-587-0912
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2011-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAAPO1525367500000X
TX585344367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered